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Is Dental school worth $400k tuition?
Started by JakeSill
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No, for most people these days.
I was fortunate and did HPSP. I cannot fathom being a new grad in my region. Must be depressing as hell when reality hits after graduation.
PS: I did a $125 molar endo today at a working interview. It's a small group practice that would never hire a new grad. Wrap your brain around that.
I was fortunate and did HPSP. I cannot fathom being a new grad in my region. Must be depressing as hell when reality hits after graduation.
PS: I did a $125 molar endo today at a working interview. It's a small group practice that would never hire a new grad. Wrap your brain around that.
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schmoob
$125 in production or collection?
Excuse my ignorance, but does that mean that was $125 worth of production, or do they only expect to collect $125?
-Is $125 the amount they reimbursed you for the procedure despite it being an interview? I'm not too well versed on the entire legal aspect of liabilities and such for these situations.
-Is that the amount you would receive as a partner? As profit after overhead?
Again I apologize, I'm not trying to interrogate or anything, I'm legitimately curious.
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$125 is the contracted insurance fee. DHMO. That's what the office got paid. Yes these plans exist.
I was on a per diem so I don't really care as I like doing endo.
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deleted547631
No one really actually wants to, they're forced to because attending dental school and paying for it these days is a losing proposition for those borrowing full cost of attendance and without family support or an inheritance. If an applicant was truly seeking a military career they'd have enlisted or commissioned prior.
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schmoob
That's a really broad, overgeneralized statement.
And it's wrong.
If NO one really wants to, how come there are career military dentists? With your logic, there shouldn't even be one.
No one is forced to do anything. Please get your facts straight.
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deleted547631
Don't get me wrong, I love the .mil life and I have many relatives serving in the armed forces honorably.
Just a fraction of the nearly 6000 annual dental graduates enter the military. What is the retention rate of those HPSP recipients once their active duty service commitment is completed? It's quite low. Would the majority of pre-dents applying for the HPSP do so if they were guaranteed a spot in a Texas dental school? No.
It's pretty obvious I was generalizing a bit but everyone here knows people pursue the HPSP primarily to offset tuition.
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schmoob
The majority of military dentists I know are career - many from Texas.
I won't say that there is no truth to your statement, because many do go strictly for financial gain. But some of them also snag a residency while they're in, and it adds time to their commitment. Once they finish residency, and subsequently pay it back, they are well on their way to a career. That means a good paycheck, no overhead, no production goals, medical and dental coverage, GI BILL, and a retirement at 20 to go and open up a practice.
Again, your statements are bold. Please provide some references for your statistics so we can break down the numbers.
The mitary is not all about sunshine and rainbows, there are times that it really sucks. but there actually are those out there that want to be dentists, and want to serve in the military.
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deleted547631
My statements are not 'bold'. What are you not understanding about my post? Medical and dental students do the HPSP for the money - it's a tit for tat tradeoff of time in the service for tuition and stipend coverage during school. A few stay in after their commitment to hit their 20 years because there are some good perks in that, agreed. No one with 400K+ debt is looking to choose active duty military service without the HPSP or PSLF as it's unrealistic to pay that all back on a military officer's salary.
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schmoob
Like I said, I agree that money is a big factor. But we're not talking about accession, we are talking about retention. Many do their time, and move on. Many others do end up staying. Most of the docs I dealt with were O4-O5, with even some O6's peppered in.
You also say that no one is looking to go AD without HPSP or PSLF. Agreed. Why? Because they have bills to pay. So, we're on the same page here. But that's an incentive to compete with the private sector. How many would go WITHOUT those incentives? Not many, because they would be FORCED to go private due to their debt obligations, despite wanting to serve.
You say that people don't want to, they're are forced to. No one is forced to do anything. There are MANY options for paying back $400K. They may not be the optimal choice or something the new grad WANTS to do, but it's an option. They can go rural where demand is high and cost of living is low. They can also put in 60+ hour weeks while living in a little apartment and driving a 96 Corolla. They can open a practice in those areas, or work in a FQHC where they would still be eligible for PSLF, as well as receive payback incentives from the state, if they exist in that area/county.
The idea is that many grads decide that now that they've finished school, they DESERVE to live the life they want. And for the ones who go HPSP, they may go in expecting to pay it back and pull chocks as soon as their time is up, but 4-5 more years is a lot of time for maturation and personal growth, at which time perceptions change. During this time they may develop a fondness for the military, or actually enjoy the lifestyle. The retention bonuses are a plus too. Some choose to leave because they hate it. Some choose to leave because despite enjoying it, they want to move on to the next phase of their life. Others stay and go career.
You think it's any different for physicians? The difference is that they are required to do an intern year AT LEAST, then their 4 years of payback. But most choose to do a residency, and some do a fellowship. So let's average that out to 5 years post graduation. Now they have AT LEAST 5 more years to pay back. Now they're at 10 years-11 years. Yet still, many decide to stay even though they joined for the money despite being debt free, board certified, with the freedom to work where they want. In fact a good friend of mine just hit 11 years, selected for O5, and is choosing to stay. His specialty would pay him significantly more in the private sector, AND he went to school with a high cost of living, so despite HPSP, he still had loans to pay and this was before PSLF.
How about USUHS? That's an 8 year minimum payback without residency, so it's really closer to 10 at least That's a long time. What's their incentive to go to this program when other opportunities exist?
As for the ones who do HPSP STRICTLY for the tuition with the intent of serving their "sentence," dodging every deployment, milking the system, complaining about the mil life every day, and bolting out the door with their benefits the first chance they get - well, they hold a special place in my heart. Not saying everyone needs to go career, but if this is seen as a business transaction instead of a service commitment, then I don't think it's fair to the other applicants who do not get accepted because they weren't able to BS their personal statement or interview as well. Military is service, people need to understand that.
Oh, and what's with the comment that if people really wanted to join the military, they would've enlisted or commissioned prior? I don't see how that's relevant if someone wants to be a dentist.
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deleted547631
All good points about life as a military health professional and trends of those that choose to go .mil. My point still stands, HPSP is about the money. The 'scholarship' exists because hardly anyone would join without such a massive perk. For most incoming dental students accepted to NYU, USC, et al applying for HPSP, the numbers work out in their favor.
Speaking for the world's finest Navy, almost half of new dentists are staying in beyond their initial obligation. If I wouldn't have to move every 2-3 years, I would very seriously consider making military dentistry my career.
Big Hoss
Big Hoss
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deleted678432
Don't want to throw shade on my school, but thought this was too crazy (and somewhat relevant) not to share. The infamous Dr. Snow: http://articles.philly.com/1999-05-30/news/25517023_1_drug-dealer-drug-kingpin-unusual-drug
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a private school is not worth the tuition. however, state schools like WVU are much cheaper, you recieve a great education (small class size, lots of hand on) and if you dont have one within your state you can always go HPSP if youre into the military. Thats what i am doing. i recommend Air Force or Navy. Im Ex-Army and would not recommend as a dentist
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schmoob
Why wouldn't you recommend the Army as a dentist?
You stand to make ~$200 x ~30 = $6,000,000 over your lifetime.
Average Joe will make ~$55 x ~40 = $2,200,000 over their lifetime
Your student loans will cost you dearly of course, with interest and depending upon your repayment rate they could cost you over $1,000,000, meaning your lifetime earnings dip to $5,000,000 or so.
You still more than double the income of average Joe and he worked what is probably a crummy job 10 years longer than you will get to be a dentist.
Average Joe will make ~$55 x ~40 = $2,200,000 over their lifetime
Your student loans will cost you dearly of course, with interest and depending upon your repayment rate they could cost you over $1,000,000, meaning your lifetime earnings dip to $5,000,000 or so.
You still more than double the income of average Joe and he worked what is probably a crummy job 10 years longer than you will get to be a dentist.
I love your analysis and thank you for sharing it. You inspired me to do an analysis for people considering public health careers since it's not likely that someone working in a CHC (such as myself) will hit 200K:
- I know several general dentists making ~130-150K after 10 yrs of experience. $150K is approximately $625/day, which is higher than what most grads even in corporations/private practice are offered (usually ~$500-600/day).
- One of my mentors told me- it's not about how much you make; it's about how much you get to keep. Dentists are naturally in a higher marginal tax rate than the Average Joe making 55K. Assuming you put nothing into pre-tax accounts for either the Average Joe or the Dentist, the Average Joe has a 12.6% effective tax rate while the Dentist making 150K has a 21.4% effective federal income tax rate. On top of this, Dentists have higher FICA and state income taxes than the Average Joe (which I will not take into account in this analysis).
- After 30 yrs, the dentist will take home after taxes $150,000 * 30 * .785 = $3,532,500. If you subtract your $1,000,000 loan repayment figure (quite realistic given the $500K loans people are taking out), the dentist is down to $2,532,500 in after-tax numbers.
- After 40 yrs, the Average Joe will take him after taxes $55,000 * 40 * .874 = $1,922,800.
Conclusion: The dentist will take home $2,532,500 in his career. The Average Joe will take home $1,922,800 in his career. This is a 31.7% increase in income, which is a significant increase. That said, the increase in income will be lower than this since the dentist will have higher state income and FICA taxes that I did not take into account in this analysis.
**Bonus point: I could have taken into account PSLF and loan repayment programs to assist the dentist working in public health. However, the future of PSLF is extremely uncertain, and IBR/PAYE all carry a huge tax bomb. Loan repayment programs have become extremely competitive (with some CHC directors reporting ~40 applicants for 1 dentist position in a CHC offering the ability for NHSC loan repayment).
I'd say that your numbers are rather pessimistic. First of all, you are giving $55k for Average Joe as his salary after taxes, which is not accurate. The average American now earns ~$52,000 before taxes. So, applying your 12.6% effective tax rate would reduce their take home salary to $45,448.
Secondly, dentists earn ~$158,000 or $172,000 according to the BLS depending on where you look. From what I understand, these numbers are often lower than what an actual typical income would be (more on that later), but out of an abundance of caution let's go with the $158,000.
So, taking your 21.4% figure, we are left with $124,888.
30 yrs @ $124,888 = $3,725,640
40 yrs @ $45,448 = $1,817,920
$1,000,000 in loans (god help anyone who actually pays this much, again it is a worst case scenario) leaves the dentist with $2,725,640.
That is a difference of $907,270. That makes for a cushy retirement, buys you a very nice home, or a small yacht. Realistically, most people will not pay $1,000,000 unless they are financially imprudent, and half of dentists will earn more than $158,000. You have to factor in the large number of semi-retired older dentists, young associates, and part-time dentists (many women take time to have children and raise families) which also depress the income statistics for general dentists.
There is plenty of money to be made if you work hard. The dentists I know who own practices are all making at least $250,000.
If you are able to pay back your loan in less than 5 years, you will probably spend ~$600,000 which means that you would have earned $1,307,270 more than Average Joe just because you exercised some delayed gratification and put off the new car and home until the loans were paid.
That said, something needs to be done about the student loan crisis in this country.
Pretty sure it is quite a bit more than that. (the interest I mean)
What are the current average rates on student loans?
about 5.8 and 6.3. Averages out to about 6%
But it's not x 6% = 24 x 4 years
It's roughly 100 x 6% for 4 years - so 24k
200 x 6% for 3 years - 18k
etc.
So if we do actually include state/FICA the difference is even less
Now if we take into account the time-value of money, a ten year head-start in investment will make the difference even smaller. And that's ten years that the dentists missed out on being able to contribute to a tax-deferred account.
http://static1.businessinsider.com/...277-1160-870/chart-jp-morgan-retirement-1.jpg
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This is a HUGE/critical point. Thanks for bringing it up.
In my original post, $55K was pre-tax, not post-tax. If you look at the fourth bullet point, you'll see where I included the multiplier to convert it to post-tax accumulated over 40 years.
You are right that if you own your own practice, your income potential is higher. $250K seems quite possible in that situation.
That said, public health dentists do NOT make the $172,000 one of your sources suggests, on average. I know the director of a dental clinic (high HPSA score) who has been there for 25 years and is making $150K. Anecdotal, sure. But I highly doubt anyone in public health is climbing past $150-160K.
You may be right that my numbers are "pessimistic," but I'm of the view that it is better to plan for the worst case/be conservative in financial calculations, than plan for the best case and risk falling short.
This is exactly why when I do my own retirement planning calculations, I assume a conservative 6% market pre-tax average annual rate of return (instead of the 9% we have enjoyed in the last decade).
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Then the interest is on a $400k student loan will most certainly be a lot more than $75k. Many people have no idea the power of interest working AGAINST you on big loans like mortgages and student loans. During the early years of a loan, MOST of your payment is for interest, and the principal is only slowly whittled down until about halfway into the loan.
Perhaps look into some of the calculators that are available for mortgages, etc.
Just plugged $400k at 6% paid off in 10 years into one:
http://www.finaid.org/calculators/scripts/loanpayments.cgi
Loan Calculator
Loan Balance: $400,000.00
Adjusted Loan Balance: $400,000.00
Loan Interest Rate: 6.00%
Loan Fees: 0.00%
Loan Term: 10 years
Minimum Payment: $50.00
Monthly Loan Payment: $4,440.82
Number of Payments: 120
Cumulative Payments: $532,898.41
Total Interest Paid: $132,898.41
Note: The monthly loan payment was calculated at 119 payments of $4,440.82 plus a final payment of $4,440.83.
As you can see, the interest is almost TWICE the estimate of $75k interest in the post above. These numbers are also assuming repayment is immediate and there is not a period where interest accumulates while one is still in school, deferring payments etc. Also, I would hazard that even as a dentist, it is likely to take MORE than 10 years to pay the loan off. With those factors, one could very easily pay in the neighborhood of $200k in interest alone, on $400k in student loans.
The low estimate in this thread stuck out to me, because I recently refinanced the remaining balance on my home mortgage, $550k, on a 15 year fixed at 2.875 (historically the rate on this kind of mortgage has only dipped lower one or two times, and that was in the last few years, and it didn't stay lower), using a bi-weekly payment plan, where the mortgage will be paid off in just over 13 years. At this super low rate, making every payment on time, I will pay just under $120k in interest over the life of the loan. (if memory serves).
Let's just agree that $500,000 in non-dischargable loans at a 7% interest rate sucks. And it sucks to suck. Until tuition is so high that it hurts a school's recruitment, it's only going to go up more.
Big Hoss
Big Hoss
We definitely agree.
In fact, it sucks a lot more than most people realize, as my post above illustrates.
Because the majority of students think "oh I'll be a doctor, it won't be a problem to pay those loans", it is doubtful that the schools will EVER have a problem filling their classes with students more than happy to pay the freight.
Student loans also have a huge impact on ones earning potential over a career, I posted extensively on this in another thread:
The amount of debt that I see new dentists graduate with is truly staggering. The steep rise in tuitions, even at state schools, over the last decade is almost criminal. Couple this with the fact that schools are expanding, and new schools are opening, and the stage is set for a very difficult time for young dentists in the foreseeable future.
My understanding from talking to dentists older than myself is that we are seeing a similar cycle to the 70's and 80's, when dental schools were pumping out more than one class per year, and larger classes, as a knee jerk response to a perceived shortage of dentists. This created a surplus which made making a living harder for many dentists (although certainly nobody was starving, lol). When I was in the military in the late 90's, early 2000's, many of the senior dentists had come into the military after failing in private practice. We may be seeing the same type of situation again in the very near future.
A couple of thoughts on debt.
Debt can be crippling in many ways. Many may think "oh it's just $300 or 400k, and I will be making $200k, so I will easily pay it off". Not so fast, Kemosabe. If you owe $400k, at a moderate to high interest rate, where most of your payments go towards interest for the vast majority of time a loan is in effect, you will end up paying much more back. This is compounded by the fact that you are paying back your loans with after-tax income. So suddenly that $150k income is more like $120 (or less, if you have state income tax), and you begin to see how many years it can take to dig yourself out of that hole.
Here is another real crapper as far as this goes. Most dentists won't make the really big bucks until they are practice owners. While one can do well as an associate, the fact remains that the owner (corporate or private) is still going to try to pay you as little as possible, while profiting off the top - nothing wrong with that, it's the way of the world - otherwise where is there incentive to provide you with a job. Making the leap from associate or employee dentist, to practice owner dentist is going to be MUCH more difficult with that kind of debt. It will be VERY difficult to find a financial institution willing to loan a young doc enough to purchase a thriving existing practice with good cash flow, or even enough to build out a scratch start practice (which is becoming very difficult as most desirable areas to live in are saturated or over-saturated). Any institution that does offer access to that type of loan, will probably not be doing so at the best interest rate and/or terms.
This will have the effect of "trapping" many young dentists into corporate dentistry, which is expanding at an alarming rate. And while for many the pay isn't bad, it certainly isn't going to be a whole lot for someone who spent 8 years of difficult study, working in a fast-paced high stress setting, who has to make loan payments in the thousands of dollars a month.
And lets not kid ourselves. After working that hard in school and after a couple of years of corporate dentistry, most young docs will feel the need to reward themselves with that nice BMW or Porsche or Mercedes, and want to upgrade their standard of living to at least a nice upper middle class home. So even before investing in a practice, they will still have $300k plus in student loans, plus maybe a $50k car loan, and a mortgage for $300k. The car and mortgage loans are also much EASIER to get approved for and to get than a business loan to build or buy a practice. THIS then serves to make it EVEN MORE DIFFICULT to make the leap from employee dentist to OWNER dentist.
Just a few thoughts from my tired brain before I hit the rack.
As always, YMMV.
While we compare who will be ahead financially (Dentist v Taco Bell guy), the tide is rising on everyone - future generations specially.
Real and Current Economic Data in 2016:
Real and Current Economic Data in 2016:
- Consumer Price Index (what we pay for goods and services) has been below 2% for the past decade, and will probably continue to remain at that level or below for the next few years. What does this even mean? Well, the change in CPI is used to measure inflation. Why should you care? Because CPI effects everything in our economy, from wages to monetary policies. So income for the most workforce, including professional jobs will remain stagnant. Basically, the economy has been in a limbo status with a very minimal growth overall for the past decade.... Except!
- Tuition has been on a different track, and has been rising 5-10 folds year to year relative to inflation. Student debt has soared and changed the economic landscape for younger and future generations. The opportunity cost in getting educated is largely and slowly becoming a risky investment, and can no longer guarantee the returns we saw in the 1980-2005. $50-100k undergrad schools are here, $500k+ dental schools are becoming the norm, $200-300k on many dental residencies are now standard. Compounding interest on student debt will easily make monthly payments $5k+ soon for those doctors.
- Does the future look bright or bleek in Dentistry and for the rest of the economy? I think everything has been spoken for for the next 20 years imo. We have become a nation that lives and feeds on debt. Majority of things we will do in our lives will be acquired via debt (education, home, car, owning a practice, real estate investments, etc), and collectively they are a risk that could be on the edge when you look at the macro scale picture. Society as a whole is pushing the envelope on the limits on how much we should borrow, while lenders are making easier to borrow more, and the middlemen (schools, employers, etc) exploit the system to their advantage, and dictate and set future debt levels for society. Unfortunately, the majority of people (including dentists) will be falling on the wrong side of the wage gap and missing out on their financial goals and dreams.
I am talking about the principal that will be owe the moment you walk out.
The interest that will capitalize when someone graduates. Along with an annual 5% increase in tuition every year (about national average of most dental schools), that 400k becomes 475 in FOUR years. Before a new grad gets a chance to earn a single dime. That's why I brought it up. Since even you used 400k to project interest on a ten year repayment plan when you should have actually used 475k as your starting principal.
My estimate dont seem too low anymore, does it?
Here's my math proving how accumulating interest for THREE years for a THREE year school still yield nearly 50k in interest.
And hell. since we want to talk about the long term. we might as well even go further down the rabbit hole. The total interest a new graduate would pay isnt even the tip of the iceberg
Let's say you graduate with 475k. Ten year plan at 6%.
Using a financial calculator, that becomes 632k for a ten year monthly payment of $5237
Now let's look at that number using an investment calculator
At an annual return of 5.5% ( I think that's pretty modest)
$5237 monthly contribution for ten years for a total contribution of 632k
At the end of 30 years that amount can grow to $2,815,973
The opportunity cost is unreal
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We have a government which is handing out loans to banks at extremely low interest rates while charging us 6% or 7%. Who does the government work for? Why is our government actively profiting off of our educational loans?
@cacazor Your clinic director can obviously afford to make $150k as they graduated 25 years ago. How do you plan to afford your loans on less than that?
The pendulum will swing the other way eventually. No one knows when, but it happened for dentistry in the 70s and caused many school closures and a collapse in school applicants. The lack of competition from new dentists entering the field resulted in a golden era for dentists which lasted a couple of decades. When the education becomes prohibitively expensive and the payoff is insufficient to justify the schooling then you will see a decline in applicants. It may take years, even decades though. Markets don't have foresight, they respond, and they tend to respond slowly.
@cacazor Your clinic director can obviously afford to make $150k as they graduated 25 years ago. How do you plan to afford your loans on less than that?
The pendulum will swing the other way eventually. No one knows when, but it happened for dentistry in the 70s and caused many school closures and a collapse in school applicants. The lack of competition from new dentists entering the field resulted in a golden era for dentists which lasted a couple of decades. When the education becomes prohibitively expensive and the payoff is insufficient to justify the schooling then you will see a decline in applicants. It may take years, even decades though. Markets don't have foresight, they respond, and they tend to respond slowly.
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you tagged the wrong person
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Woops, thanks. @Incis0r
What's up, bud?
Given a modest 3% annual tuition increase, is it conceivable that we may see schools with a total cost of attendance north of $650,000 within a decade? I'm an advocate of the HPSP, but I can totally see Uncle Sam capping what he'll pay in tuition if the absurdity continues. I'm actually surprised this hasn't happened already.
Big Hoss
Big Hoss
Yep. I think this is going to happen as well.
True. I am also surprised that UOP students get to get away with a three year obligation with a school that cost more than most 4 year schools
Maybe they should start using cost of attendance as an admission criteria lol.
But it seems like the medical side is still hurting for physicians so maybe things will never change since dental & medical fall under one big umbrella under HPSP
IMO its not worth serving in the military just for loans, its only worth it if youre patriotic and have an interest in serving your nation. Maybe its also worth it if you never plan to open your own practice b/c, you know, you likely wont be making as much as business-owning dentists.
It's not like you will stay in the military forever...
The military is still very much financially worth it. Hell with the way taxes work, if HPSP dentists received no salary they would still come out ahead compared to someone trying to pay off their loans after their service commitment.
It's financially worth it, but you can't do it just for the money. Because you WILL make other sacrifices.
Why are we comparing ourselves to the average joe? I'd love to see this same comparison made with our fellow MDs (say GP dentist with GP dr). Who's coming out on top?
I saw another poster do the comparison and I wanted to try out the exercise for my own situation, out of pure curiosity.
If don't want to deploy anywhere "unpleasant" do NOT join the military - we HATE whiners.. go work for a chain to pay off your loan
I see. Is it possible for you to check out a comparison between GP dentists and doctors? I'd be really interested in reading your analysis.
I've heard that the more rural you go to practice the higher your income will be. Does anyone have any thoughts/insights on this?
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Supply and Demand. Demand is higher in rural areas, dentist wages/salary goes up.
Thanks for the compliment- it means a lot coming from you.
Way back when I was a pre-med, I would gladly have done this for you. But I am not up to date on physician salaries and the programs available to family medicine practitioners (besides the obvious S2S, PSLF, etc) so I must respectfully decline.
If you come up with some numbers on the medical side of it (training length, starting salary, hours worked/week, etc), then I'd be glad to compare that with what I've learned from my time speaking with and shadowing general dentists.
Worse for GP physicians IMO. They typically have a little less debt than dental students, but they have a residency which will not pay them enough to allow them to pay down their student loans. That is extra interest accrual over several years for a residency which will earn then roughly the median dentist's salary. Couple that with their higher malpractice and the likelihood they will be sued. Also, the fact that they spend so much of their time dictating and filling out ICD-10 forms. They spend a lot of time on the clock which they are not compensated for.
General dentists start sooner, earn about as much, have lower malpractice, and work significantly less hours.
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The statistics that I have read from many sources over the years (the ADA provides great sources on this, based on surveys done every few years) doesn't completely support what you have heard.
While there are some rural areas where there is a good micro economy (think North Dakota in the last decade, parts of Alaska, parts of Texas like Odessa/Midland, etc) and dentists do very well, statistics seem to show that when practicing in a true RURAL area, dentists don't tend to do as well, mainly because there are not that many patients, and the average income level is low.
What I have taken from my reading, is that there is a "sweet spot" where dentists do best. This is often a small town (not truly "rural", or "out in the country"), where there is a good balance of not too many providers (as in over saturated desirable places to live metro areas - think all of the major metro areas in California), but plenty of patients, with good middle or upper middle class incomes, and a good dental health IQ.
In highly saturated areas, too many providers creating lots of competition driving fees down, high cost of living driving high wages for staff, combine to keep average dentist incomes in the lower levels for many, if not most.
In truly rural areas, not enough patients with disposable income and a desire for comprehensive dentistry.
Agree with much of what you wrote.
I would never recommend family practice or pediatrics for my kids, should they become physicians. While I do know of primary care physicians who do very well, I would say that your statement about incomes being similar to general dentists is more the norm. Not enough ROI, IMO. Becoming a dentist or a physician is a lot of time and work. Because of the several extra years of residency for even primary care doctors, their education more closely compares to dental specialists, who on average, outlearn MD primary care doctors by quite a bit.
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deleted547631
I think your purview needs updating.
FM and IM docs are starting at $250K/year out of residency for M-F 8a-5p or hospitalist 7/7 positions these days. They also have ample opportunity to take on extra moonlighting shifts at $130+/hr, add 40% to that for nocturning in a rural hospital or rural ED. Demand is through the roof for primary care docs right now and for the foreseeable future. Also, most new physicians I speak with have student loans at around $200K and are able to pay them off in less than a year if they really wanted to. This is an awesome time to be a physician.
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deleted547631
Dentistry's moving towards Pharmacy's model, which is predominantly corporate churning with huge downward pressure on salaries. The best ROI is shifting back towards medicine, in my opinion.
Said no physician ever... But seriously physician vs dentist is like comparing living in North America vs Europe. There are so many factors and differences it's very hard to effectively compare. Now add differences between individuals (hopes, dreams, aptitudes, locale preference, etc.) and it gets even harder. Yada yada... grass is always greener as well. This pissing match is never constructive. What I think we can all agree on is that rural medicine/dentistry pays better than urban, for the majority of clinicians. But that's just simply supply and demand.
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